COMPARISON OF 3 MEASURES OF INJURY SEVERITY IN CHILDREN WITH TRAUMATIC BRAIN INJURY

Eighty-six traumatically brain-injured children aged 6 to 15 years who were consecutively admitted to a pediatric Level I trauma center were recruited for participation in the study. A comprehensive battery of behavioral, cognitive, commuuicative, social, motoric, and neurologica l tests was administered to the children from 12 to 36 months postinju ry. The performance of three severity indices, the Glasgow Coma Scale (GCS), the ASCOT probability of survival, and the head injury componen t of the Anatomic Profile, was compared with respect to their associat ion with longterm outcomes in five neurological domains, as assessed b y linear regression models. The ASCOT probability of survival was corr elated to test scores in all five domains. The GCS and the head injury component of the Anatomic Profile were each correlated to outcome in only one domain. The ASCOT probability of survival, which includes cod ed variables for the GCS, systolic blood pressure, and respiratory rat es on admission, as well as a measure of multisystem anatomic injury, was the most sensitive indicator of head injury severity and was assoc iated with outcomes beyond survival and death in this population. Prob ability of survival is a promising brain injury severity index that ma y be useful in efforts to assess new medical and rehabilitative therap ies for children with traumatic brain injury.